Tissue characterization of progressive cardiac allograft vasculopathy in patients with everolimus therapy compared with donor-transmitted atherosclerosis assessed using serial intravascular imaging: A case report

T. Watanabe, J. Kotani, Y. Murata, O. Seguchi, M. Yanase, T. Nakatani

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Using serial intravascular ultrasound (IVUS), integrated-backscatter IVUS, and optical coherence tomography, we observed rapidly progressive cardiac allograft vasculopathy (CAV) and donor-transmitted plaque in the left anterior descending artery. Late-phase everolimus-resistant CAV had a rapidly progressive course (maximal intimal thickness [MIT] increased by 0.5 mm between years 3 and 4 after cardiac transplantation, from MIT growth <0.5 mm at year 1). Conversely, the donor-transmitted plaque grew slowly (0.1 mm increase during the same period). Tissue characteristics in the 2 segments were also different; CAV had eccentric, noncalcified, and lipid-rich components and was associated with macrophage accumulation, whereas donor-transmitted atherosclerosis presented with typical features of atherosclerosis (ie, fibrocalcific plaque). CAV with late-phase progression involves everolimus resistance and features of vulnerable plaques seen in nontransplantation patients and is independent of donor-transmitted atherosclerosis.

Original languageEnglish
Pages (from-to)2456-2461
Number of pages6
JournalTransplantation Proceedings
Volume46
Issue number7
DOIs
Publication statusPublished - 01-09-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

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